Medically tailored meals (MTM) are an evidence-based intervention that provides fully prepared meals to individuals with serious or chronic health conditions. While initially developed as a critical support for people living with HIV, MTM programs have expanded to serve individuals with various health needs, including congestive heart failure, chronic kidney disease, uncontrolled diabetes, and cancer. While food insecurity is not typically a requirement for MTM program eligibility, these programs complement their primary clinical benefits by also improving access to nutritious food — a key health-related social need (HRSN).
How do medically tailored meals programs work?
EVIDENCE ROUNDUP
This blog post is part of a Playbook series connecting evidence and implementation resources with emerging state and federal policies to help enhance services for people with complex needs.
Individuals typically access MTM through a referral from a health care provider to a community-based MTM provider. A registered dietitian nutritionist (RDN) designs each recipient’s meal plan to meet their specific medical needs while accounting for cultural preferences. The fully prepared meals are usually delivered to recipients’ homes and may be accompanied by nutrition education. Many MTM providers maintain accreditation through the Food is Medicine Coalition, which sets standards for program quality and implementation. While MTM programs often provide long-term support for individuals with serious or chronic health conditions who face challenges with daily living activities, they can also serve as a short-term intervention — for instance, during post-hospital recovery, pregnancy, or to address acute health needs such as elevated HbA1c levels.
What is the policy landscape for medically tailored meals?
The 2022 White House Conference on Hunger, Nutrition, and Health — the first such event since 1969 — called for expanding access to MTM. Building on this momentum, November 2023 federal guidance on state options to address HRSNs through Medicaid included specific provisions for MTM, indicating that MTM can be provided through managed care in lieu of services or settings (ILOS), home- and community-based services (HCBS) authorities, and HRSN 1115 demonstrations. Although MTM is primarily designed as a clinical intervention targeting nutrition as a determinant of health — rather than an HRSN intervention — several states are now including MTM within broader strategies to address HRSN through Medicaid. For example, New York, Pennsylvania, Oregon, and Washington all include MTM as covered services in approved or pending HRSN 1115 waivers, while in California, Medicaid managed care plans can offer MTM as an in lieu of service through the state's CalAIM Community Supports program.
What is the evidence behind medically tailored meals programs?
There is a growing body of evidence indicating the effectiveness of MTM programs in achieving several key outcomes, including reduced hospitalizations and patient costs and improved clinical outcomes.
- Association Between Receipt of a Medically Tailored Meal Program and Health Care Use – This study analyzed the impact of a 10-week MTM intervention on admissions to hospitals and nursing homes for people with complex health and social needs. Among 1,020 study participants, receipt of MTM was associated with a 49% reduction in inpatient admissions, 72% fewer admissions to skilled nursing facilities, and 16% lower health care costs compared to individuals with similar demographic and clinical characteristics who did not receive MTM.
- Association of a Medicare Advantage Posthospitalization Home Meal Delivery Benefit with Rehospitalization and Death – A study of nearly 12,000 Medicare Advantage members found that receiving home-delivered meals after hospitalization reduced rates of 30-day rehospitalization and mortality.
- Association of National Expansion of Insurance Coverage of Medically Tailored Meals with Estimated Hospitalizations and Health Care Expenditures in the US – This economic evaluation estimates that national implementation of MTM for individuals with nutrition-sensitive conditions and limitations in activities of daily living would lead to over $13.6 billion in cost savings per year, primarily through reductions in hospitalizations.
What do medically tailored meals programs look like in practice?
The following resources offer insight into how MTM programs are designed and implemented:
- Implementation Considerations for Medically Tailored Meals – This report provides recommendations for policymakers, health plans, and providers on implementing MTM programs.
- Nourishing Seniors Through Medically Tailored Meals – Insights from experts, recent research, and state case studies offer actionable recommendations for advancing MTM initiatives to improve outcomes and reduce costs.
- Medically Tailored Meals for Older Adults: Evaluation Report – This evaluation of an MTM pilot program shows improved diabetes management among 51 older adults with diabetes. It also features implementation tools and templates from the pilot, including the 12-week diabetes education course curriculum, intake form, clinical assessment form, MTM program menu, and recruitment materials.
Share Your Medically Tailored Meals Resources and Tools
Do you have a resource or emerging best practice related to MTM programs? Share your experience with the Playbook. We are interested in growing our library of evidence and implementation best practices to help those in the field strengthen and build successful MTM programs in communities across the nation.